Wine as an antibacterial

Wine gums

One of the components of red wine protects against tooth decay
May 31st 2014 | From the print edition
Timekeeper

jerusalem dentist

WITHOUT regular brushing and flossing, teeth accumulate bacterial films that secrete acid and cause cavities (see article). But sometimes even these good habits are insufficient to shift such films, and a chemical called chlorhexidine has to be deployed as well, in the form of a mouthwash. Chlorhexidine, however, stains teeth and affects people’s sense of taste, so an alternative would be welcome. And Victoria Moreno-Arribas of the Institute of Food Science Research in Madrid believes she may have one: a derivative of red wine. jerusalem dentist

Dr Moreno-Arribas knew from previous work that red wine has antimicrobial properties, but she could find few studies which looked at whether it attacks dental biofilms specifically. To rectify that, she and her colleagues grew five troublesome oral bacteria, Actinomyces oris, Fusobacterium nucleatum, Streptococcus mutans, Streptococcus oralis and Veillonella dispar, on discs of hydroxyapatite, the main component of dental enamel. They fed the bugs by dipping the discs into solutions of sugar mixed with saliva collected from volunteers, who spent several hours spitting into jars. The results have just been published in the Journal of Agricultural and Food Chemistry.

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Wine gums
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jerusalem dentist
As expected, the bacteria grew to form films on the discs, just as they do on teeth. After a week of such growth the researchers exposed each disc to one of five treatments every day for a further seven days. Some were swished around in red wine (a pinot noir, vintage 2010) for two minutes. Some were swished in a de-alcoholised version of this wine. Some were swished in chlorhexidine, some in a 12% solution of ethanol (ie, of the same alcoholic strength as the wine) and some in plain water. This combination of experiments let Dr Moreno-Arribas determine whether wine has antibiofilm properties beyond those bestowed by its alcohol content, and also how well it compares with chlorhexidine.

Sadly for oenophiles, chlorhexidine still came out on top. But wine did well against two of the five species, F. nucleatum and S. oralis. Intriguingly, in the case of S. oralis the de-alcoholised version was even more effective than the full-strength stuff.

To find out which chemicals within the wine were having the desired effect, Dr Moreno-Arribas and her team added wine extracts such as flavanols and yeast polysaccharides to the mix and repeated their experiments. The magic turned out to be provided by a group of chemicals called flavan-3-ols.

Regrettably, this work does not suggest that a nightly glass of wine is a sensible substitute for a thorough dental brushing before you go to bed. But it might, if pursued, allow an alternative to chlorhexidine mouthwash to be developed—perhaps one that does not have such a horrible effect on taste buds.

computerized dentistry in Israel

Computerized Dentistry

Israel has long been at the forefront of computerized dentistry. The use of digital x-rays , CT’s and CAD-CAM  dental restorations has been around for  20 years or so. We were the first office in the country to adopt the CEREC porcelain dental crown system.

Having just upgraded to the new Cerec Bluecam, I wanted to share some thoughts on what this means for my patients. CEREC blue cam is a state of the art dental 3d capture device. It allows us to avoid taking messy goopy impressions of your teeth, and allows a simple digital image to do the job.CEREC blockcomputerized dentistry

Then, on the screen we design your restoration together and we see magic as the computer itself makes the crown fit between your teeth. Some adjustment is usually necessary by the dentist but we quickly reach the point where with the press of the button the milling unit literally create the crown out of a block of porcelain. It is computerized dentistry at it’s finest.

Here is one of the advantages of the new CEREC 4.2 software. It allows computerized dentistry to actually fit the models of the upper and lower jaws together digitally. It shows me exactly where the teeth all touch allowing our final restoration to have a perfect fit and bite.Cerec occlusion computerized dentistry

Computerized dentistry has come into it’s own in the last decade or so. We can now restore dental implants using this system, as well as doing porcelain veneers. The fit is unparalleled and the esthetics and time savings are tremendous. There are a host of new materials  that have been developed for this system and I have no doubt that we will see even greater advances in the future.

For now we can say without a doubt that CEREC is at the forefront of computerized dentistry and that it offers an unparalleled  service to our patients.

CEREC Before And After  Smile Design

CEREC before treatment CEREC AFTER

طبيب الأسنان القدس

طبيب الأسنان القدس

Our office offers a unique blend of old Jerusalem charm and warmth, with a cutting edge hi-tech dental environment. We provide an unusually wide range of services from general anesthesia for fearful adults and children to CEREC TECHNOLOGY for one hour porcelain crowns and esthetic dentistry. I have been treating the international community here since Aliya in 1988, including the international press, the diplomatic corps, and the UN. We are located in the Gan Technology, the premier high tech center in Malha, Jerusalem, near the Malha Mall.
Sincerely,
Dr. Ari Greenspan

 

طبيب الأسنان القدس

 

favicon طبيب الأسنان القدسنوفير مجموعة واسعة من الخدمات على نحو غير عادي من التخدير العام للبالغين والأطفال وصولا الي تكنولوجيا الزرعات الخزفية الجراحةخلال  ساعة واحدة ,والتيجان الخزفية وطب الأسنان التجميلي. لقد عالجت كثيرا من اعضاء  المجتمع الدولي هنا منذ علية في عام 1988 ، بما في ذلك الصحافة الدولية ، والسلك الدبلوماسي ، والأمم المتحدة. نحن موجودون في تكنولوجيا قان ، المركز التكنولوجي العالي   في المالحة ، القدس ، بالقرب من مجمع المالحة.
مع خالص التقدير ،
د. آري غرينسبان

مع خالص التقدير ،
د. آري غرينسبان

  • A graduate of University of Medicine and Dentistry of New Jersey
  • خريج  من جامعة الطب وطب الأسنان في نيوجيرسي
  • Lecturer in the Hadassah Dental School
  • محاضر في كلية طب الأسنان في مستشفى هداسا
  • A member of the American Dental Association
  • عضو في نقابة أطباء الأسنان الأمريكية
  • A member of Israel Dental Association
  • عضو في نقابة أطباء الأسنان اسرائيل
  • Past president of the Jerusalem Anglo Saxon Dental Study Club
  • الرئيس السابق للأنجلو ساكسون نادي القدس دراسة طب الأسنان
  • Frequently attends dental conferences
  • كثيرا ما يحضر مؤتمرات طب الأسنان
  • Completed four levels of the Pankey Institute
  • • أنجز أربعة مستويات للمعهد شعوزة
  • Specialty Services
  • خدمات متخصصة
  • CEREC-Israels first and most experienced dentis in CAD_CAM technology. Crowns in one hour.
  • زرعات خزفية  من الدرجة الأولى في  إسرائيل وأكثرها خبرة في مجال تكنولوجيا( كاد-كام) كل هذا في ساعة واحدة
  • Specialty in full porcelain crowns
  • متخصصون  في التيجان الخزفية الكاملة
  • Sleep disorders
  • اضطرابات النوم
  • TMJ-Facial pain
  • ألم المفصل الفكي الصدغي ،  في الوجه
  • Tooth Whitening
  • تبيض الأسنان
  • Bad Breath treatment
  • علاج رائحة النفس الكريهه
  • Occlusal disorders
  • اضطرابات الإطباق
  • One of a handful of locations approved for Sedation and General anesthesia for children and adults by the the Ministry of Health
  • واحد من عدد محدود من المواقع المعتمدة للتخدير العام وتخدير الأطفال والكبار من وزارة الصحة
  • Laughing gas
  • غاز الضحك
  • Implants
  • زراعة الأسنان
  • Root Canal
  • حشوة العصب
  • Pediatric dentistry
  • طب الاسنان للأطفال
  • Digital X-rays- 80% less radiation
  • الأشعة السينية الرقمية ، 80 ٪ أقل من الإشعاع

Recent continued dental education:

مجالات جديدة في طب الأسنان اتمتمها حديثا:

  • 2009 Medical emergencies in the dental office
  • 2009 حالات الطوارئ الطبية في مكتب الأسنان-
  • 2009 Bone grafting techniques update
  • • 2009 تقنيات حديثة في تطعيم العظام
  • 2009 CT scan interpretation course
  • 2009 كورس في تحليل نتائج الاشعة المقطعية
  • 2009 Sleep disorders and dentistry
  • 2009 اضطرابات النوم وطب الأسنان
  • 2008 Functional occlusion and orthodontic
  • • 2008 الانسداد الوظيفي وتقويم الأسنان
  • 2008 Implant complications and bone augmentation
  • 2008 مضاعفات زرع العظام وزيادتها
  • 2008 Bone augmentation surgical course
  • • دورة في جراحية العظام و زيادتها 2008
  • 2008 3D implant placement
  • • 2008 البعد الثلاثي  وضع الزرعة باستخدام نظام
  • 2007 posterior porcelain mechanics
  • 2007 ميكانيكا الخزف للأسنان الخلفية
  • 2007 Anterior esthetics
  • • 2007 الجماليات للأسنان الأمامية
  • 2006 Israel Dental Expo
  • • 2006 معرض طب الأسنان اسرائيل
  • 2006 Removable and fixed Prosthodontics
  • • 2006 التركيبات الثابتة والقابلة للإزالة
  • 2006 Cleft Palate- updates in treatment
  • 2006 الشفة الأرنبية، التحديثات في العلاج
  • 2006 cast inlays and onlays
  • الحشوات البديلة عن المعدن 2006
  • 2006 women”s health issues and dentistry
  • 2006 قضايا الصحة النسائية وطب الأسنان
  • 2006 Pharmacology review
  • استعراض الصيدلة 2006
  • 2006 Implant advances
  • تطورات زراعة الأسنان 2006
  • 2005 Greater New York Dental Meeting
  • اجتماع نيويورك الأسنان العظيم 2005
  • 2005 Esthetic dentistry
  • 2005 طب الأسنان التجميلي
  • 2005 occlusion
  • إطباق الأسنان2005
  • 2005 Dr. Christianson Dentistry Update
  • الدكتور  كرستيانسون –تطورات طب الأسنان  2005
  • If you need, dental implants, porcelain crowns, general anesthesia, or tooth whitening please be in touch soon.

إذا كنت في حاجة ، زراعة الأسنان ، أوالتيجان الخزفية ، أوالتخدير العام ، أو تبييض الأسنان يرجى أن تكون على اتصال في أقرب وقت

The cost of dental implants

What is the cost of dental implants in Israel ?

cost of dental implantsTo understand the cost of dental implants, we need to understand the steps involved:

Extraction of teeth

If you need to extract a tooth that is not salvageable, then  you must take that into account. In Israel, extractions range from 350 NIS-2000 NIS depending on degree of difficulty and surgery involved.

Bone Graft

Is there enough bone to place the implant? Once we extract, we often decide to place a bone graft so as to prevent losing bone height, which normally happens after an extraction . Also, there are times that we need to raise the floor of the maxillary sinus for more bone . This is called a sinus lift. Depending on degree of complication and surgery involved this  can cost  anything from 650-5000NIS.

Dental Implants

The actual implant surgery is straightforward. There are 3 stages to the implant restoration which compromise the cost of dental implants.cost of dental implants

Implant – This is the actual implant that is in the jaw which will hold the post and crown once it heals and fuses with the bone. 3500-4500 NIS

Post – the item that is screwed onto the implant which holds the crown. It is  highly precise, and is made to exactly fit your implant. There is zero tolerance for failure or fracture and has to be of the highest quality. 1200-2200 NIS

Crown– The cap that looks like the tooth which is cemented onto the post. 3500-4500 NIS

Why is the cost of dental implants so expensive?

There are a number of  factors that make  the cost of dental implants so high. The materials themselves as well as the cost of laboratory  manufactured pieces are great factors. Also, the dentist has invested tens of thousands of shekels in equipment specifically for placing the implants and restoring them. There are often numerous A happy patient after implantsworkers who are involved in providing the service. The dentist  often invests tens of thousands of shekels in training and continuing education in order to stay on top of developments in the field. Finally, you want and dentist who is good and takes responsibility for his work. All of that comes with at a cost.

Comparing apples to apples

There are many advertisement out there that sell implant restorations for a very low price. Caveat emptor– let the buyer beware. All dental implants are not the same and all dentists are not as well. Choose one that is nice, good and has an excellent reputation for service and reliability and you will not be sorry with the result.

 

 

 

 

 

Wisdom Teeth : Pain And Problems

Wisdom teeth

Wisdom teeth are the 3rd molars that erupt into our mouths from about age 18. These are the back teeth in each quadrant of the mouth. Often times, there is  not enough room in the mouth for the wisdom teeth, and a host of problems can occur.

Pericoronits

When the wisdom teeth erupt, there is usually a little flap of gums that covers the back of the tooth. This little pocket of tissue  makes it very easy for food and debris to get caught underneath it and this can create an infection. pericoronitisInitially, it is tender and may bleed when brushed. People will nit clean it since it hurts. However, that only makes the problem worse, by allowing the bacteria to flourish. This causes a swelling of the gums over the wisdom teeth that can be very painful. Sometimes, patients complain of earache, neck ache, and even fever as a result of a pericoronitis.

The treatment for most of these painful wisdom teeth problems is conservative. Cleaning the soft food debris away from around the wisdom teeth will minimize the inflammation. So every time you eat, while you have the pain, you must brush the area gently to make sure it is clean. This minimizes the bacterial load. We also suggest a mouth rinse of salt water or a chlorohexadine mouthwash like Tarodent or Corsodyl. If the area is cleaned like suggested it can begin to improve in 12-24 hours.

Impacted Wisdom Teeth

Since many times there is not sufficient room in the mouth for these teeth, they erupt in all sorts of angles and locations. Impacted wisdom tooth There is a need for extraction many times. We often will refer them to an oral surgeon for the surgery, as it can be quite extensive. Post operative sweeping and infection is often a concern and the area must be kept clean for optimum healing. We often find a large defect in the bone after extracting wisdom teeth. We sometime will place a bone graft in the socket to ensure optimum healing.

What’s it like being a dentist in Israel ?

hi Yirmiyahu
Here is the story from my perspective. There is potential here to earn a very good living as a dentist. Is it easy ? no, but i dont think it is easy in the US either. having tremendous debt burden though is not the way to make aliya. it took me 10 years to pay off my $35k loans 25 yrs ago. Then again I never worked a day in the US and took the jump.

There is always opportunity in any market and anyplace. having said that you must have skills , dynamism and excitment that others don’t. good communication skills, business skills and technical skills seem like an obvious thing but most dentists dont have all 3. you can be the greatest technical dentist in the world but if you dont know how to interact in a way that attracts people, you will fail.
you need a diploma from a dental school to work and must take an Israeli dental exam. If you pass the US boards, you will pass the Israeli dental exam. I think the reason that many dentists are traveling back and forth to the US, has to do with what time in their career they made aliya. If you are coming from a developed US practice, and you have a family of older kids, and you have become accustomed to a certain quality of life, it is very hard to go cold turkey and start from scratch . However, once you are on that wagon train, it is virtually impossible to get off. However sexy it might seem to some, to earn a good US salary and live in Israel,traveling like that is a great strain on your body marriage and family.
Work hours vary. when i started I worked like a maniac, 6 days a week full time. I quickly was getting burnt out and went to an unusual 4 day intensive workday. When I went from 6 to 4 days, income went up 25%. Today I do a 4 day 12-14 days a month workday. Dentistry is a hard but very fulfilling profession. It is sometimes physically difficult as well as you are sometimes twisted into uncomfortable positions. But that has nothing to do with Israel.

Dentistry in Israel , for me , has been wonderful. I have gotten to know thousands of people, who like me, and have the opportunity to help me as well, over the years. I have helped employees earn a good living and sent their kids to school through my salary. I have had the opportunity to do a tremendous amount of charity by doing free dentistry for some people who needed it. And, I have earned a good living while doing it. If I can be of any help , let me know.

Ari

Orthodontics in Jerusalem

Jerusalem Israel Orthodontics

Orthodontics is a great way to give people with crooked teeth a perfect smile.

We generally prefer to move teeth when the bone is not fully mature, as it is softer that that of an adult. Usually the ideal age is just when the baby teeth have fallen out. Somewhere between 11-14 years old.

Interceptive Orthodontics

There are certain cases where interceptive orthodontics can be done at an early יישור שינייםage in order to prevent problems later. Oral habits like thumb sucking cause the teeth to protrude. Stopping the habit is a sort of interception that might use an orthodontic appliance. Another example is if a baby tooth is lost early and the space where it was is not held open. Then the drifting teeth might prevent the permanent tooth from coming down into place. In these cases, a space maintainer is the solution, as it holds the space open till the adult tooth comes in.

Sometimes, the upper teeth erupt into a position that is inside the lower teeth. A normal esthetic bite is such that the upper teeth are outside of the lower teeth. By orthodontics Jerusalemplacing a simple appliance in the child’s mouth, we can easily guide the permanent tooth into place.

 

Adolescent Orthodontics

The most common orthodontics is that done to an adolescent. The teeth have just come in, the body is still growing and we can easily move them to where we want them. While it may look simple there are many factors an orthodontist takes into account while he is planning the treatment. The Dr. must evaluate the skeletal pattern of the child and the estimated growth that will happen later on. Specialized x-rays called a cephalometric and a panoramic x-ray are needed for this. Digital x-rays greatly reduce exposure to radiation.

orthodontics cephalometric

Cephalometric X-ray

יישור שיניים orthodontics panoramic

Panoramic X-ray

Computerized orthodontics or brackets?

Once the plan has been made there are two basic approaches to treatment. The standard was always using brackets to hold a wire which imparts the gentle forces on the teeth. Ultimately a rectangular wire fits in a slot in the bracket and the teeth move into a very precise location as well as being tilted in the ideal direction.

 

In recent years, a new approach is used where a computer calculates all of the steps needed to get from the beginning to the end. Clear plastic is molded into a form which fits on the teeth with slight pressure. invisilign orthodonticsThat pressure causes slight movement. After two weeks or so another plastic form is placed on the teeth causing a bit more movement. After 12-24 months or so, the teeth have moved into the desired location due to orthodontics without wearing any unsightly brackets.

 

For information on orthodontics in Jerusalem, please be in touch.

 

 

Obstacles for women seeking dental treatment during pregnancy

FAMILY MAY 6, 2013

Obstacles for Pregnant Women Seeking Dental Care

By CATHERINE SAINT LOUISDentist in Jerusalem pregnant dental care

In pain because of infected teeth, Luatany Caseres, 34, then a factory worker in Durham, N.C., was desperate to see a dentist.

At an emergency dental clinic that treats the uninsured, a receptionist told Ms. Caseres that the schedule was full. When she returned a second time in still greater pain, the receptionist told her, “I can’t get you seen.” On her third visit, Ms. Caseres’ swollen cheek bulged as if a lollipop were stuck there. Still, she was told that she would have to wait.

Why? “It was because I was pregnant,” Ms. Caseres said. She was in her second trimester, and the receptionist said she needed a doctor’s note before the office would consider treating her.

Dental treatment during pregnancy

Finally, Ms. Caseres found Dr. George Soung, a fourth-year dental student who was trained in a new prenatal program at the University of North Carolina at Chapel Hill. By that time, two premolars had broken to the gums, exposing nerves. Her pain was so acute she was bedridden, taking sleeping pills and painkillers.

Dr. Soung extracted Ms. Caseres’s two abscessed teeth at once, because a far-gone infection could spread to the jaw or even throughout the body. “This wasn’t something that popped up a week ago,” he said. “Nobody would treat her.”

Too many pregnant women like Ms. Caseres are not getting timely dental care, experts say. There are plenty of reasons: Some dentists are reluctant to treat pregnant patients, in no small part because of outdated thinking. OB-GYNs too often fail to check for oral problems and to refer women to dentists. And many women fail to seek out oral care or mistakenly think it’s dangerous, even though pregnancy itself may lead to gum inflammation.

The problem among dentists is decades old. Many “were taught in dental school that you can’t treat a pregnant woman,” said Dr. Renee Samelson, a professor of obstetrics and gynecology at Albany Medical Center, who was an editor of the first guidelines on oral health in pregnancy, which were published by the New York State Department of Health and advised on two more sets of guidelines. Dentists simply erred on the side of caution, she added: “There was no evidence of harm.”

Today, although dental treatment during pregnancy is considered beneficial, some dentists still hesitate to see pregnant women, because they fear litigation or harm to the fetus, or their knowledge of appropriate care lags behind the current evidence. One 2009 survey of 351 obstetrician gynecologists nationwide found 77 percent reported their patients had been“declined dental services because of pregnancy.”

Dentists fear offering dental treatment during pregnancy

“A lot of dentists still fear treating pregnant women, and think, ‘What happens if I have to do an X-ray?’ or ‘What happens if I give antibiotics or local anesthesia?’” said Dr. Howard Minkoff, the chairman of obstetrics and gynecology at Maimonides Medical Center in Brooklyn. “None of these are legitimate reasons not to provide appropriate care for women.”

Since 2006, a few state organizations and dental associations have issued practice guidelines declaring that dental care is safe and effective at any stage of pregnancy, including diagnostic X-rays, cavity restorations and root canals.

OB-GYNs should check for bleeding gums or oral infection and refer a patient to a dentist if her last visit was longer than six months ago, according to the first national consensus statement on dental care during pregnancy, published in September by the National Maternal and Child Oral Health Resource Center at Georgetown University.

The statement advised dentists to provide emergency care in any trimester. OB-GYNs can be consulted, as necessary, if a pregnant patient is diabetic or hypertensive, or if general anesthesia is required.

Dr. Sally Cram, a periodontist in Washington, and a spokeswoman for the American Dental Association, said dentists she knows provide complete care. She added, “In the last 10 to 15 years, a lot of dentists have promoted the importance of pregnant women having regular cleanings.”

Delaying oral care can have serious consequences. Gingivitis, or gum inflammation, affects 60 to 75 percent of pregnant women, and left unchecked, it can become periodontal disease. Untreated periodontal disease can lead to tooth loss. And a mother with active tooth decay can spread cavity-causing bacteria to her child through saliva, perpetuating poor oral health.

Pregnant women with dental pain also may self-medicate inappropriately. In a March 2001 letter to the New York State Department of Health, a doctor described a patient who was unable to get urgent care for her abscessed teeth in upstate New York. She took such excessive doses of Tylenol that she developed acute liver failure, and the fetus died. That prompted the drafting of new state guidelines.

Still, some OB-GYNs do not address oral health during visits with pregnant women, an oversight that angers some dentists. “If you take your dog to the vet, the first thing they do is look in their mouth,” said Dr. Nancy Newhouse, a periodontist in Independence, Mo., and the president of the American Academy of Periodontology.

Many pregnant women simply don’t seek dental care, perhaps out of misplaced fear or neglect. Some states offer dental Medicaid benefits to low-income expectant mothers, for example, but utilization rates are low.Only 28 percent of eligible women seek and receive services in Oklahoma. In New York, 41 percent of pregnant women on Medicaid visited dentists in 2010, up from 30 percent in 2006.

Such a multifactorial problem requires a coordinated effort between OB-GYNs and dentists to reach mothers-to-be, said Dr. Stefanie Russell, a dentist and an epidemiologist at New York University. But for women with low-risk pregnancies, she said, “things will change when women realize dental care is their right during pregnancy.”

Deborah Acosta contributed reporting.